"The Hospital" Medical Book Supplement.—No. XI

Diseases of the Spinal Cord. By R. T. Williamson, M.D., F.R.C.P. (Oxford Medical Publications. Henry Frowde and Hodder and Stoughton. Pp. 432. 183 figures. Price 15s. net.) This book is an amplification of a course of lectures delivered by the author during the past fifteen years at the Manchester Medical School, on which it reflects credit. It presents in clear language a reliable account of our present views on diseases of the spinal cord. One of its most conspicuous merits is that whilst taking full cognisance of contemporary neurological literature, the writer succeeds in preserving a personal atmosphere, a refreshing thing in dealing with subjects on which too many authors are mere fielders of scissors and paste. It is impossible in a brief review to give an adequate account of the material so assiduously collected. After introductory chapters on the structure of the spinal cord and on its general pathological histology, the writer discusses the functions of the spinal cord and gives an account of the symptoms of spinal diseases; this latter chapter, owing to its relative brevity, is hardly up to the standard of the rest of the book. Electrical examination, skiagraphy and lumbar puncture are placed together and discussed in a special chapter. Then follow interesting chapters on the diagnosis and localisation of the various spinal-cord diseases, with an appendix

presents in clear language a reliable account of our present views on diseases of the spinal cord. One of its most conspicuous merits is that whilst taking full cognisance of contemporary neurological literature, the writer succeeds in preserving a personal atmosphere, a refreshing thing in dealing with subjects on which too many authors are mere fielders of scissors and paste. It is impossible in a brief review to give an adequate account of the material so assiduously collected. After introductory chapters on the structure of the spinal cord and on its general pathological histology, the writer discusses the functions of the spinal cord and gives an account of the symptoms of spinal diseases; this latter chapter, owing to its relative brevity, is hardly up to the standard of the rest of the book. Electrical examination, skiagraphy and lumbar puncture are placed together and discussed in a special chapter. Then follow interesting chapters on the diagnosis and localisation of the various spinal-cord diseases, with an appendix on the methods of pathological examination. The references to other authorities are partly included in the text, Partly grouped in lists at the end of each chapter; from the reader's point of view it would have been better to adopt one or other of these arrangements, not both. As a "whole, however, the book is an excellent one and will be most valuable both to the senior student and to the practitioner.
Common Affections of the Liver.?By W. Hale White, M.D., F.R.C.P., Senior Physician to and Lecturer on Medicine at Guy's Hospital. (London : James Nisbet and Co. 1908. Pp. viii. + 302. Price 4s. 6d. net.) This is not a text-book, but rather a series of clinical lectures upon the liver. It represents bedside teaching, and as such it possesses that personal charm which is unfortunately lacking in so many modern works of multiple authorship. Treatment is entered into in greater detail than is usually the case in clinical lectures, and the advice given is most practical and to the point. It might be expected that " biliousness," " torpidity of the liver, and so forth, would find a large place in a work bearing the title " Common Affections of the Liver." Readers who expect this will perhaps be disappointed to find them dealt with in a single page, and excluded upon the ground that they have probably little or nothing to do with the liver at all. The author's remarks upon the subject are crisp and concise, but we should very much like to have been given a full clinical lecture upon "biliousness." Although biliousness is thus excluded from the conditions dealt with at any length, the reader will find admirable chapters upon such subjects as jaundice, displaced liver, diseases of the liver vessels, congestion of the liver, suppuration in and around the liver, cirrhosis of the liver, perihepatitis, syphilis of the liver, malignant disease of the liver, tuberculous, lardaceous, actinomycotic, and hydatid diseases of the liver, acute yellow atrophy, and icterus neonatorum. The book is of convenient size, and the type is clear and large ; the volume is light to hold, pleasant to read, and, at the same time, most instructive. This book gives an interesting and fairly clear account of the origin, technique, applicability, usefulness, and comparative value of the tuberculo-cutaneous and of the tuberculo-ophthalmic reactions for the detection of tuberculous lesions.
It is a pity that there should be any soreness of feeling between Calmette on the one hand, and Wolff-Eisner on the other, as to which of the two was the first to discover what is now generally known as " Calmette's reaction," but which, it seems, was discovered by Wolff-Eisner ; and one cannot help feeling that there is an uncomfortable strain of "I was really the first to discover this" all through the book. This, together with the fact that there is no index, is a serious objection to the volume ; but the descriptions given by the author, both of the methods themselves and of the results that may be obtained by their use in all kinds of conditions, render the book one which will be of considerable assistance to medical practitioners. It is probable that in time certain objections will be found to both the cutaneous and the conjunctival tuberculo-reactions, and limitations to their value; such objections and limitations are scarcely to be looked for in the book of an enthusiast; but notwithstanding that, the author here gives a very fair summary of what has been found out up to the present. The translator leaves t e style distinctly German in many places.

SURGERY.
Injuries of Nerves and Their Treatment. By James Sherren, F.R.C.S.Eng., Assistant Surgeon London Hospital.
With much that appears in this volume we have been made familiar by Mr. Sherren's previous writings, and we are now afforded a review of the whole subject which cannot fail to be of the greatest interest to every surgeon. The results from the researches of the author and Dr. Head are briefly reviewed. We have still some doubts as to the anatomical entity of separate fibres for epicritic and protopathic sensation; it is a matter which seems hardly to admit of experimental proof, but be the dissociation of function anatomical or physiological there can be no doubt of the value of the findings to the clinician. The great advance in neurological diagnosis that has been brought about by the study of dissociation of sensation is nowhere better illustrated than by the ease with which we are now able to differentiate between lesions of the conus and cauda equina by considering whether the segmental sensory loss be of peripheral or cord type, though, of course, this is only true in the?fortunately commoner?event of the cauda lesion being incomplete. In speaking of the reaction of degeneration the author does well not to lay stress on the complicated phenomena of polar change with which it is unfortunately still the custom to torment the student. The experience of the author in facial-hypoglossal anastomosis must be happier than our own when he says that '' in any case we may confidently predict great improvement to follow the operation." The thorny subject of peripheral regeneration is treated briefly; it has always appeared to us that the results of Betlu with continuous nerve loops give an almost incontrovertible proof of autogenous peripheral degeneration in the young mammal. We are far from sure that the early use of electrical treatment recommended is advisable. There is experimental evidence that a cut nerve degenerates far more rapidly when subjected to laradic stimulation than when left alone. It is probably better to defer electrical treatment till signs of regeneration have set in. The book is well illustrated by photographs of cases; an inspection of that on page 180 shows the well-marked effect of sympathetic palsy on the pilomotor muscles of the eyebrows, a clinical sign frequently overlooked. The work can be warmly recommended to both surgeons and neurologists, and constitutes a most valuable addition to our knowledge of the clinical pathology of the peripheral nervous system. Since the introduction of antiseptic surgery the treatment of hernia by trusses has been largely superseded by operation for radical cure. In fact it is no exaggeration to say that a radical cure is nowadays performed in every case if there is no real contraindication to operation; in this way our knowledge of the state of affairs found in hernise has become very exact. In this book Mr. Murray has some remarks to make on the causation and on the treatment of hernia. He is strongly inclined to the view that whether a hernia be "congenital" or "acquired," the peritoneal sac which forms its covering is present beforehand : in other words, the hernia descends into a potential sac already present, and rarely, if ever, pushes its peritoneal investment before it. In this sense all hernise, except perhaps the direct variety, are congenital, and it is an accident which deter-mines whether the sac is formed by the unobliterated processus vaginalis or by an accessory pouch of peritoneum unconnected with this. It follows that in the question of treatment the all-important factor is to remove the sac as completely as possible. As long as this is done the result will be equally good whatever method be adopted for the rest of the operation. The author advocates a method, first introduced by Lucas Championniere, in which the edges of the cut aponeurosis are made to overlap, and he has followed up a number of his cases to prove that the after results are satisfactory. Undoubtedly they are, but then so they are by any method as long as the sac is completely removed.
Price 3s. 6d. net.) Many small publications, of a quasi-scientific character, upon cancer are cropping forth just now, and we have already expressed our views about the printing of immature and one-sided views upon the subject. There is nothing either new or striking in the volume before us, nor does it contain anything very helpful. The views expressed by the author have long ago been expressed by others, and a very great deal of research work has been, and is still being, done upon them by those who are far better acquainted with the subject than Mr. Bigg seems to be. One point in the volume that merits attention is its last paragraph but one : " Scientific research starts from near the finish, and not from the commencement, of the disease, so that the investigation is not only incomplete, but is inaccurate." It is quite clear from this that Mr. Bigg is unfamiliar with the immense amount of histological work done by such skilled authorities as Professor Ribbert. The theories that Mr. Bigg propounds are neither new nor his own; and although he says in his preface that "the right to an opinion is a universal privilege, but the expression of it becomes a duty when it is considered to be for the good and benefit of others," we think it a pity that Mr. Bigg felt that it was a duty to cumber the world with a wholly unnecessary publication. Pp. 531. Price 9s. 6d. net.) The composition of a text-book on diseases of the eye is probably as difficult a task as any in medical literature; a text-book, that is to say, designed for students and practitioners. The subject is a vast and complicated one, and it must be condensed into a compass suitable to the needs of those who have but little time to devote to the subject. On the other hand, there must be included some account of every condition which may be met with in practice, and of its treatment, and there must be an attempt to explain two processes which most students find inexplicably difficult?retinoscopy and the examination of the fundus. It follows that anyone who starts out to write such a book must be both an experienced surgeon and a sympathetic teacher; we should imagine from the internal evidence of this book that Mr. Jessop is both. The critical eye notes two minor omissions, at least; but, taken as a whole, the book is excellent and well worthy of the popularity of which this re-issue is evidence.
PUBLIC HEALTH AND HYGIENE. precisely what sort of subject-matter it contains. It would even be difficult to .say whether it is intended for the laity, or for the profession, or for both. It certainly comes as a surprise to find that it is practically a lay sermon upon the text " Anaemia." There is doubtless a deal of truth in what the author says, and we are far from pooh-poohing the work; but we feel that when he traces the cause of almost every ailment to anaemia he is going too far, just as we think that those do, too, who look upon uric acid as the source of most human illnesses. There is little doubt that work in towns and cities, in workshops and in factories, tends to diminish the richness of the blood in haemoglobin.
W e agree that persons whose blood is below par are less able to resist disease than are those whose blood is in perfect order. We agree that in the best interests of the national physique each individual should live as far as possible such a life as will not tend to impoverish the blood. Fresh air and sunlight are amongst the best remedies for ansemia. ^ e become weary, however, of the constant reiteration of the word " Anaemia." The title would have made the nature of the subject-matter clearer had it been "Anaemia, the Main Cause of Physical Deterioration and of Many Common Ailments." Dr. Simpson has written a small and intelligible pamphlet in book form admirably suited for the instruction of mothers or nurses on the simple methods of diet and on some of the minor troubles connected therewith. Thirty-three pages are devoted to breast-feeding, two to weaning, and the rest to artificial feeding. The advice given is sound and practical. We do not countenance two-hourly feeds for as long as six weeks to two months, and think the intervals should be prolonged to three hours before the end of the fourth month. The scalding or boiling of milk is recommended under certain circumstances, but no reference is made to the necess'ty of rapidly cooling the milk and keeping it in the cold if it has to be kept for further use. We suggest to the author that on revision more precise tables for diet during the first month should be given, and that the gradual education of the child in the digestion of starch should be brought about by the introduction of barley-water into the milk mixtures during the third quarter of the first year of life. Of the authorities quoted Cautley deserves to have his name properly spelt. The book is quite useful, and with a little care could be made still more so without unduly enlarging its scope.
MASSAGE. There is one point which is bound to limit the extent to which this work is read in Great Britain?namely that oi anguage?it is written entirely in French. It is clear, owever, that it should find a place in every medical or surgical library in this country. The views of the authors aie no doubt biassed, as they are almost bound to be, in favour of the beneficial effects of massage in a great many different abdominal conditions; but the volume is not massage ' from end to end.
There is a long chapter devoted entirely to the anatomy of the stomach and intestines, with their blood and nerve supplies, and a very great deal of trouble has been spent upon large and good illustrations which cannot but be useful both to anatomists and to surgeons. Another long chapter is devoted entirely to the Physiology of digestion, including not only secretion, chemical action, and absorption; but also motility, a part of the subject which is apt to be left out in text-books of physiology. The authors devote another chapter to the effects of massage upon the physiology of digestion; they do not merely state beliefs; they have carried out extensive experiments, gastric juice analyses, and so forth, and they draw conclusions from these as to the way massage of the abdomen acts upon the activities of the underlying viscera.
They give further experimental results to show the actual results of massage in cases of chronic constipation, biliousness, diarrhoea, hyperchlorhydria, nervous, cardiac, and anaemic dyspepsias, mucous colitis, enteroptosis, gastrectasis, the vomiting of pregnancy, the after-effects of sea-sickness, and so forth. Not only this, however, but they also give precise details of the methods of abdominal massage, illustrated by very clear full-page pictures of the different stages and processes. We think the publication steers clear of fads to a very considerable extent, and, although it has massage for its basis, we think it includes so much besides that it must be regarded as a scientific treatise containing points that interest the anatomist, the surgeon, the physiologist, the physician, the general practitioner, and the specialist in massage. We may add that the entire publication consists of three volumes, of which the above is the second.

EMBRYOLOGY.
Quain's Anatomy. Vol I. Embryology. Longmans, Green and Co. 1908. Price 10s. 6d. net.) The recent advances in our knowledge of human embryology have necessitated very considerable additions and changes in this volume of " Quain's Anatomy," and the present edition has been re-written by Dr. Bryce and many new illustrations have been added. The first section on "General Embryology," which will of course be eagerly read, is perhaps the least satisfactory. It is questionable whether it would not be wiser to confine the attention to human embryology in a work which is essentially a treatise on human anatomy. The excursions into comparative embryology lead to considerable confusion, and it is not always clear whether reference is made to human embryos or to those of some other animals, e.g. on p. 41. The description of the pre-reduction, reduction, and post-reduction phases of the development of the sex cells is so condensed as to be hardly accurate. It was Farmer and Moore, not Moore and Walker, who introduced the terms pre-maiotic, maiotic, and post-maiotic, which they spell as here, and not as the author spells them on p. 17. These criticisms notwithstanding, it is a pleasure to welcome a new edition which embodies the recent work on human embryology, and the present volume will be of great value to workers in this subject.